| NPI | 1275669921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY5055) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: GU PY5055) |
| 103TH0100X Psychologist Health Service (Licence: FL PY5055) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-11-25 |